Impact of crush syndrome severity on clinical outcomes after the earthquakes in southeastern Türkiye
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Crush syndrome is a potentially life-threatening complication of prolonged compression injuries, frequently encountered after earthquakes. The 2023 Kahramanmaraş earthquakes in Türkiye caused extensive crush-related trauma. The objective of this study was to assess the effect of baseline crush syndrome severity on hospitalization outcomes and complications. METHODS: In this multicenter, retrospective observational study, 962 crush syndrome patients hospitalized after the earthquakes were evaluated. Patients were grouped as mild-moderate vs. severe-critical based on clinical presentation. Demographics, laboratory results, comorbidities, trauma types, complications, and outcomes were assessed. Comparisons between groups were performed using the Mann–Whitney U test and chi-square test, and survival analysis was conducted with the Kaplan–Meier method. RESULTS: Of 962 patients, 232 (24.1%) were classified as severe-critical and 730 (75.9%) as mild-moderate. “Severe-critical patients had significantly higher rates of hypotension (38.8% vs 2.3%), ARDS (10.2% vs 1.7%), sepsis (31.7% vs 9.1%), DIC (8.5% vs 1.4%), arrhythmias (11.9% vs 0.8%), compartment syndrome (53.5% vs 36.9%), and ICU (95.6% vs 40.9%) requirement than mild-moderate (all p<0.001)”. Laboratory markers including BUN, creatinine, potassium, phosphorus, liver enzymes, CK, and CRP were all significantly elevated, while calcium and albumin levels were lower in the severe-critical group (p<0.05). Kaplan–Meier analysis revealed a significantly lower survival rate in the severe-critical group (67.7% vs. 97.7%, p<0.001). Trauma types such as cranial, abdominal, and thoracic injuries were more frequent in this group, and prolonged entrapment time [median 18 (8-40) vs. 10 (6-33) hours, p<0.05] was correlated with increased severity. CONCLUSIONS: Crush syndrome severity at admission is strongly correlated with clinical outcomes, complication rates, and in-hospital survival. Prolonged time under the rubble, systemic complications, and elevated muscle and renal injury markers contribute to worse prognosis. These findings highlight the need for rapid triage, timely fluid resuscitation, and organized multidisciplinary intervention in future disaster scenarios.
Source: BMC Nephrology
Authors: Kenan Turgutalp, Savas Ozturk, Neriman Sila Koc, Murside Esra Dolarslan, Ismail Kocyigit, Didem Turgut, Tuncay Sahutoglu, Dilek Torun, Ozlem Usalan, Orcun Altunoren, Ramazan Danis, Gursel Yildiz, Ali Gurel, Mehmet Horoz, Mehmet Kucuksu, Suleyman Karakose, Mehmet Riza Altiparmak, Mehmet Deniz Ayli, Murat Tugcu, Zehra Eren, Tolga Yildirim, Fatma Betul Guzel, Nedim Yilmaz Selcuk, Esra Akcali, Dede Sit, Mehmet Polat, Saliha Yildirim, Selma Alagoz, Sibel Bek, Irem Pembegul, Tahsin Karaaslan, Funda Sari, Ayça Inci, Numan Gorgulu, Mahmut Gok, Zeki Aydin, Kubra Bahat, Yavuz Ayar, Serap Demir, Zeynep Ebru Eser, Murat Hayri Sipahioglu, Bahar Gurlek Demirci, Meliha Ozkutlu, Engin Onan, Ahmet Alper Kiykim, Ayse Serra Artan, Emrah Erkan Mazi, Nergiz Bayrakci, Murathan Uyar, Kubra Kaynar, Ayhan Dogukan, Sena Ulu, Serhan Tuglular
Institutions: Mersin Üniversitesi, Istanbul University, Harran University, Mersin Şehir Eğitim ve Araştırma Hastanesi, Erciyes University, Ankara Bilkent City Hospital, Şanlıurfa Mehmet Akif İnan Eğitim ve Araştırma Hastanesi, Sağlık Bilimleri Üniversitesi, Başkent University, Gaziantep University, Kahramanmaraş Sütçü İmam University, Mardin Artuklu University, İstanbul Başakşehir Çam ve Sakura Şehir Hastanesi, Fırat University, Istanbul University-Cerrahpaşa, Ankara Etlik City Hospital, Marmara University, Alanya Alaaddin Keykubat Üniversitesi, Hacettepe University, Ministry of Health, Necmettin Erbakan University, Ümraniye Eğitim ve Araştırma Hastanesi, Nevşehir Devlet Hastanesi, Gazi University, Kocaeli Üniversitesi, Malatya Turgut Özal Üniversitesi, Turgut Özal University, Akdeniz University, Antalya Eğitim ve Araştırma Hastanesi, Bağcılar Eğitim ve Araştırma Hastanesi, Dr Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi, S.B.Ü. Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Tekirdağ Namık Kemal University, Istanbul Aydın University, Karadeniz Technical University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,090
OpenAlex ID: W7127599297